Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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The news that came with the leaking of the Health Service Executive report that the HSE north-east region is contemplating cuts in services to offset an overrun of almost €10 million in the current fiscal year has come as a grievous blow to the people of counties Cavan, Monaghan, Louth and Meath, the greater number of whom live under a daily dark cloud as a result of the loss of critical services at a number of those hospitals, not least in Monaghan and Dundalk.

People in the region I represent are absolutely outraged and cannot understand that at a time when the economy is, for all intents and purposes, awash with money, the Government is presiding over cutbacks in health, which has made a serious and negative difference in the daily life condition of ordinary people. In the area where I live in County Monaghan, there have been upwards of 20 avoidable deaths as a result of the contraction in service delivery at the acute hospital site in Monaghan in recent years. That is a terrible statistic, a terrible reality and a terrible indictment of Government policy in this regard.

People have a right to ask why, after nine years in government, the coalition has got our health services so disastrously wrong. While it is acknowledged that more money is going into the health services than at any time previously, the reality is that we are not receiving the service delivery we once enjoyed and have every right to expect in future.

The Government is more keen to give tax breaks and land to developers of private hospitals than it appears to be committed to the public hospitals of Monaghan, Cavan and Dundalk, each of which has long records of excellent care for patients and is again being deprived of services. Almost incredibly, the contemplated cuts in the north east will have an effect on some of the most vulnerable of patients, those with cancer and those requiring renal dialysis, among other service user needs.

If these cuts go ahead, long-promised and long-needed improvements in oncology and dialysis services will be blocked as an exercise in a so-called money-saving endeavour. It may save money in the long term, but at what price? What price will people pay over the remainder of this year?

The focus of these cuts is incredible. There is a bounden duty and responsibility on Government to recognise that the per capita allocation of funding in the north east falls well below the average per capita allocation right across the different HSE areas throughout the State. It is now a requirement of the Minister for Health and Children, Deputy Harney, to ensure the HSE properly funds services in the north east rather than employs the exercise mooted in this report, that is, a curtailment of promised developments and improvements and a further contraction in service to allegedly save almost €10 million in the remainder of this year.

There is no doubt that diktat ending accident and emergency services in Monaghan has already contributed to the loss of lives. In respect of what other area of the country could a Deputy stand up and say what the names of Bronagh Livingstone, Pat Joe Walsh and Frances Sheridan mean to the House? I could go on and on and the truth is that each name means something to the Minister. He recognises them and he knows that their deaths occurred in tragic circumstances. No Deputy from any other part of the country could stand up and refer to the hospital services in his or her hospital area and expect such instant, national recognition of those names. There is no better way than that to explain the sad reality of the situation in Monaghan.

I hope the Minister recognises that a special situation applies here. It is not acceptable that we will have further misery heaped on the suffering, fear and concern that is prevalent in the community that I am proud to represent.

Michael McDowell (Dublin South East, Progressive Democrats)
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I am taking this matter on behalf of the Tánaiste and Minister for Health and Children.

Under the Health Act 2004, the Health Service Executive has responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. The Department has been advised by the HSE that the allocation in 2006 for the north-east hospital network is €216 million. This is approximately €15 million more than was provided in 2005, representing an increase of over 7%. Management at the hospitals in the north east are examining options to assist in meeting the requirement to operate within the approved funding allocation in the current year. The purpose of the reviews under way is to identify options that can assist with breaking even financially without impacting existing services. A number of budgetary measures have already been put in place within the HSE hospital network in the north east. The HSE has assured the Department that these budgetary control measures will not have an adverse impact on patient care, including cancer and dialysis services. The aim is to obtain best value for money and to maximise efficiencies where possible.

Staffing levels in the north-east hospital network increased from 3,091 at the end of 2004 to 3,238 at the end of 2005 and 3,301 at the end of the first quarter of 2006. This represents an increase of 210 since the end of 2004. Since 1997, cumulative funding totalling more than €36 million has been allocated to the Health Service Executive north-eastern area for the development of appropriate treatment and care services for people with cancer. This investment has enabled the funding of eight additional consultant posts and support staff in key areas of cancer care and 41 cancer care nurse specialists across the region. The HSE has assured the Department of Health and Children that an additional €600,000 will be invested in the further development of cancer services in the region this year. There are currently two consultant medical oncologists with sessional commitments in the region. The appointment of an additional consultant medical oncologist between the Mater Hospital and Our Lady of Lourdes Hospital in Drogheda is currently being processed and is a priority post for the HSE.

The HSE expects that by reviewing expenditure and applying available resources, including money put aside for contingencies, it will manage the provision of services as set out in its 2006 service plan.